In extra innings, every pitch becomes magnified, and after the Orioles' painful 8-7 loss to the Cleveland Indians in 13 innings, left-hander Troy Patton replayed one pitch in his mind.

Patton was one strike away from escaping a bases-loaded jam, but he left a 1-2 changeup to Carlos Santana just high enough for the Indians third baseman to turn on it and send it just inside the third-base line for the game-winning hit.

“Location,” Patton said. “It was the right pitch. I got him out in front. He just squeezed it into an area because I left it a little high. ... [It] just stayed up a little bit, and he was able to get enough of the barrel to hook it inside the base. Very close to the desired result right there, but he squeezed it in there.”

Santana’s two-out, two-run double off Patton broke a 6-6 tie and sent the Orioles (23-22) to their first loss in five extra-inning games this season, ending a 4-hour, 22-minute marathon Thursday in front of an announced 18,894 at Camden Yards.

It was the Orioles' longest game of the season in time and innings.

The Orioles bullpen was resilient despite being without Tommy Hunter, who went on the 15-day disabled list earlier in the day, and Brad Brach, who threw a career-high four relief innings Wednesday in Pittsburgh.

Zach Britton and Preston Guilmet combined to retire 13 of 14 hitters they faced over 4 1/3 innings before Patton entered to face left-handed hitters Michael Brantley and Lonnie Chisenhall with one out in the 13th.

Both hit looping singles off Patton, who then walked Nick Swisher to load the bases. After getting Yan Gomes to fly out to right field, Santana took a 1-2 pitch from Patton down the third-base line and under the leaping feet of third-base umpire Alan Porter to score two runs.

“Both of those two lefties got on weak contact -- on really strange contact -- so I had two guys on before I even knew what was going on,” Patton said. “It was kind of an uphill battle from there.

"I felt real good when I first came back. The last two outings have been a struggle. But other than that, I feel fine. I still feel fine. I’m throwing good pitches. It’s just some bad luck and some bad timing."

After recording six straight scoreless outings, Patton (0-1) has allowed five runs in his past two outings over 1 1/3 innings.

“Just his command's off,” Orioles manager Buck Showalter said of Patton. “He's getting a couple counts in his favor and just hasn't been able to finish the at-bat off. He's got some things that he's capable of that he's just not executing.”

After the game, Showalter retreated to his office to see if the team would need to make another roster move Friday to add a fresh pitcher for the bullpen.

Also, third baseman Manny Machado abruptly left the game before the top of the 12th inning with right groin stiffness. Showalter and Machado called the move precautionary.

The Indians (23-25) arrived at Camden Yards after winning another 13-inning game the previous day in Cleveland against the Detroit Tigers and looked like a tired team.

With wild pitching, errant throws and batted balls that fell between outfielders, the Indians gave the Orioles plenty of opportunities early in the game.

The Orioles came within one run in the bottom of the 13th on Nick Markakis’ solo homer, his third of the season, but right-hander Scott Atchison recovered for his first save.

The Orioles have scored 30 runs in their past four games, but they have a 1-3 record in that span.

“The positive aspect is we're swinging the bats better,” Showalter said. “So, you can look at it half-full, half-empty. You'd like to take advantage of that type of offense.”

They were unable to hold a 6-5 lead when right-hander Darren O’Day allowed a tying solo homer to Chisenhall, just the second run that O’Day has allowed in 18 innings this season.

The Orioles went up in the bottom of the seventh inning on Nelson Cruz’s sacrifice fly after they loaded the bases with one out -- partially because of errors by Cleveland on back-to-back plays.

Earlier in the game, the Orioles pulled ahead when Ryan Flaherty hit his first homer of the season, a three-run shot that just landed over the scoreboard in right field, to cap a five-run rally with two outs in the sixth inning to give the club a 5-3 lead.

The rally came one inning after the Orioles loaded the bases with no outs in the fifth against Indians starter Justin Masterson, but came away with no runs.

The Indians also gave the Orioles a gift in the sixth, when Adam Jones’ fly ball dropped between outfielders Michael Bourn and David Murphy -- who both halted their chase and watched the ball drop -- giving him a one-out double.

After Cruz drew a two-out walk, Steve Clevenger singled up the middle to score Jones. J.J. Hardy followed with another single to center to score Cruz.

With Masterson on the ropes, Flaherty turned on a 2-1 pitch that split the plate for his first homer since Sept. 25, 2013 against the Toronto Blue Jays.

In the fifth inning, Masterson -- who was working on three days' rest -- issued a four-pitch walk to Clevenger and hit Hardy and Flaherty with pitches to load the bases.

But No. 9 hitter David Lough, hitting just .171 after Thursday's game, hit a comebacker to Masterson, who started a 1-2-3 double play and left the field to a smattering of boos. Markakis followed with a lineout to first base to end the inning.

Trailing, 5-3, the Indians (23-25) scored two runs off Orioles starter Wei-Yin Chen in the seventh to tie the game.

The inning was kept alive when Flaherty deflected a grounder that was a routine play for Hardy at shortstop and ruled a base hit. One run scored on the next play, a groundout to Flaherty at second base, and another on No. 9 hitter Mike Aviles' RBI single.

“You use a lot of energy and concentration to get back in the game -- we were down, 3-0 -- I was real proud of that,” Showalter said. “And then we kind of gave it right back. You can say there were a couple pitches we'd like to have back, but there were also a bunch of really good pitches made to keep them at bay and give us a chance.”

Two batters later, after Bourn singled, Cabrera lifted a ball to left field that Lough caught while leaping over the wall in mid-stride to end the inning.

The Orioles took a 6-5 lead in the seventh after Manny Machado reached on a fielding error by Cabrera and Jones reached when third baseman Carlos Santana threw the ball away going for a force out at second.

After Chris Davis drew an intentional walk to load the bases, Cruz hit a sacrifice fly to center to score Machado for his 42nd RBI of the season, tying him with the Chicago White Sox's Jose Abreu for the American League lead.

Chen, historically superb working on six days' rest, fell behind by three runs through three innings, allowed a season-high five runs and eight hits over 6 2/3 innings. He entered the night with a career 2.93 ERA in 10 starts on six days' rest.

Cleveland left fielder Ryan Raburn took a 2-2 fastball into the left-field stands for a solo homer to open the second inning, giving the Indians a 1-0 lead.

The next inning, Brantley hit a two-out RBI triple down the first-base line just past the outstretched glove of Davis, scoring Bourn all the way from first. Brantley scored later that inning when a wild pitch by Chen got past Clevenger.

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